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Senate Democrats yesterday killed a proposal to limit pain-and-suffering awards in medical malpractice lawsuits, an idea strongly backed by many U.S. physicians who say high malpractice insurance costs are driving them out of business.

Democrats used a procedural vote to kill the bill, championed by President Bush and approved by the House earlier this year. The Democrats said arbitrary $250,000 caps on pain and suffering may benefit insurers and drug manufacturers, but would not necessarily help doctors or patients.

The bill would not have limited awards for economic damages, such as lost wages or medical costs, but it would have put a $250,000 cap on awards for pain and suffering and would have curtailed punitive damages.

The vote was 49-48 in favor of taking up the bill, 11 short of the 60 needed to overcome the Democrat-led filibuster. Republican Sens. Lindsey Graham of South Carolina and Richard C. Shelby of Alabama broke party ranks and voted with Democrats.

Republicans said the bill was necessary to stop a spreading medical malpractice crisis.

“The problem is caused by out-of-control jury awards in frivolous lawsuits, which are cheaper to settle … than they are to fight,” said Sen. John Ensign, Nevada Republican. “And the reason they’ll settle is because of the potential for huge awards … then pass the higher rates on to doctors.”

Democrats said rising premiums were not to blame and that the bill would punish individuals already grievously impaired by medical errors while protecting groups such as the American Medical Association, health maintenance organizations, drug companies and the manufacturers of medical devices.

“Time and time again this Senate races to protect special interest groups and forgets the families and children and elderly people across America who are the victims of this wrongdoing,” said Sen. Richard J. Durbin, Illinois Democrat.

Although Senate Republican leaders put aside the bill, lawmakers may try to work out a compromise or alternative solution in the coming months.

However, some proponents said they would take the plan to voters. Sen. Rick Santorum, Pennsylvania Republican, told reporters this week that Republicans pressed ahead with the vote knowing they would lose “so we can turn the heat up back home on senators who are not being responsive to the problems in their own states.”

Both the House and Senate have voted on similar legislation over the years, but the issue has taken on more political potency in recent months amid unusual protests and work stoppages by doctors in several states.

The influential American Medical Association has made the bill a top priority.

Backers of the legislation say big jury awards and frivolous lawsuits are causing increases in malpractice premiums so steep that some doctors, particularly in high-risk specialties like obstetrics and emergency medicine, are shutting their practices.

“This is about access to care,” said Mr. Ensign, a lead sponsor of the bill.